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Step-by-step procedure using the biologic route. (A) A K-wire is placed into the area of pathologic bone on anteroposterior and lateral fluoroscopic views. (B) A 4.0-mm reamer that can fit over the guidewire is selected. (C) The reamer is placed over the K-wire and advanced under fluoroscopic visualization. (D) The guidewire is removed, and the biologic is injected into the reamer using a spinal needle.
